For many years, the tricyclics were the most popular antidepressants. Although superseded today by the less side-effect prone selective serotonin reuptake inhibitors (SSRIs), they are still used in certain cases.

Preliminary evidence suggests that tricyclic antidepressants might deplete the body of coenzyme Q
10
(CoQ
10
), a substance that appears to be important for normal heart function.
1,2
Based on this observation, it has been suggested (but not proved) that CoQ
10
supplementation might help prevent the heart-related side effects that can occur with the use of tricyclic antidepressants.

Based on one case report
3
and our general knowledge about the actions of these supplements, taking any of these in combination with some tricyclic antidepressants could conceivably present a risk of elevating serotonin levels too high.

St. John’s wort might decrease the effectiveness of tricyclic antidepressants by reducing blood levels of the drug.
4-5
Conversely, if you are taking St. John's wort already and your physician adjusts your dose of medication, suddenly stopping the herb could cause blood levels of the drug to rise dangerously high.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.